If you know someone with anxiety, it can be hard to know the right things to say and what not to avoid.
People deal with their anxiety in their own way, and not everyone has the same ideas about what’s appropriate to say or not.
But there are some things you should be aware of that you should avoid. You can find some of these phrases and what to say instead to help you navigate conversations with friends or family members living with anxiety.
What is anxiety?
Understanding more about anxiety and how it can affect those who experience it is a good first step to supporting your family or friends.
Anxiety is a feeling of fear or worry that can range from mild to severe.
Although feeling anxious occasionally is perfectly normal, sometimes it can be hard to control, and these feelings of fear or worry surface more often and can affect daily life.
Anxiety is a symptom of some health conditions, such as:
- Panic disorders
- Phobias (social phobias or specific phobias like agoraphobia, a fear of places or situations that create feelings of anxiety)
- Post-traumatic stress disorder (PTSD)
There are also types of anxiety disorders, such as:
- Social anxiety disorder (anxiety caused by social situations)
- Separation anxiety disorder
- Obsessive-compulsive disorder (OCD)
- Generalised anxiety disorder (GAD)
GAD is also known as a long-term anxiety disorder. If you feel you might experience long-term and persistent anxiety or know someone who does, you should always speak to a mental health professional or a medical professional, like your GP. They’ll be able to talk through what you’re experiencing and create a treatment plan to help you manage. There are also different treatment options available to help treat anxiety, including:
- Psychotherapy, like cognitive behavioural therapy (CBT) or talk therapy
- Medicines – such as a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs), or anti-anxiety medicines (such as benzodiazepines)
Anxiety can cause a range of different symptoms, including physical symptoms. Some of the symptoms of anxiety include:
- Shortness of breath
- Racing heart rate
- Rapid breathing
- Restlessness or difficulty sleeping
- Finding it hard to concentrate
Helping someone you know with anxiety
Don’t ask, “are you ok?”
This is a bit of a mixed question. You do want to ask how they are, listen and be empathetic to their concerns. This is more about the wording – perhaps ask, “How are you feeling?”. This open question is more likely to lead to a conversation. A question like “Are you ok?” is a closed question, and you’ll probably get a shorter, less detailed response.
Don’t say, “everyone gets stressed/anxious”
Stress is often different to someone suffering from an anxiety or panic disorder. A busy day at work isn’t enough to be diagnosed with an anxiety disorder. Stress is a natural response when our demands outweigh our coping strategy disorders, and we can all experience stress. It’s not a recognised mental disorder.
An anxiety disorder is the presence of anxiety for a long period of time (a minimum of six months on average) that significantly impairs functioning. For example, they can’t focus on work or study, can’t care for themselves properly, or can’t take part in social activities or hobbies. However, around a quarter of people experience a mental illness, so it’s more common than you might think.
If you want to share with someone, perhaps say, “I’ve experienced stress before, but it sounds like you’re struggling quite a bit with anxiety at the moment. Could you tell me a bit more?”
Don’t say, “I’m a bit OCD” or “I’m a bit of a worrier.”
This is similar to the last point – it can be invalidating. The occasional checking of the front door or desire to keep things tidy is very different from clinical OCD. Here, someone can experience intrusive thoughts, for example, “if I don’t check this, something bad will happen to me or others I love”, which leads to a high level of distress. This distress results in compulsive checking. OCD is not something people want to do. They can’t manage their anxiety if they don’t act on these compulsions.
With worry, it’s similar. The level of anxiety results in people feeling obliged to worry about a range of things. It’s not the same as worrying about an interview, for example, which is specific and short-term.
Don’t say, “It’s not that bad” or “Just relax and calm down.”
The anxiety response is a primitive safety response designed to protect us against threats to our life. This is an evolutionary response, so it’s immediate. We can’t control the onset of anxiety. Our amygdala (the brain’s threat centre) is activated and adrenaline is released.
This sets off many physical changes in our body to protect us, almost like a burglar alarm alerting us to an intruder. This is known as the ‘fight or flight response’.
We can feel breathless, dizzy, and have an increased heart rate. If this response is triggered suddenly, it can be very scary for someone with anxiety. This can trigger more anxiety and reinforces the cycle.
It can be challenging to manage these symptoms without understanding anxiety and steps to reduce physical anxiety. Instead, it’s better to say anxiety is a short-term response designed to protect us, not harm us. Even if it feels awful, the key thing is that it will pass.
Depending on the type of anxiety, they may have such extreme physical anxiety symptoms that they may fear harm or death. With panic attacks, for example, the common thought is “I may faint or die” due to breathlessness and dizziness associated with the anxiety attack response.
If you feared you might die, being told to calm down wouldn’t be helpful. Instead, say “take a breath, and focus on your surroundings.”
Don’t say, “It will go away.”
Anxiety is essential emotional response and we shouldn’t want it to go away completely. However, it can be managed better with the proper support. They can learn when it’s helpful to be anxious and when it’s not. In situations where it’s not, you and your friend or family member can develop strategies to reduce the intensity of their anxiety.
One strategy that people use is the 3-3-3 rule. This is where you look around and name three things you can see, three sounds you can hear, and then move three parts of your body. The idea is to shift their focus from negative thoughts and panic and hopefully begin to calm their mind. This is something you can help guide them through if you’re with them during a period of anxiety.
Don’t say, “Stop thinking so much.”
Anxiety leads to overthinking and worry. Even though worrying is a natural behaviour, people with anxiety may not see it that way. Overthinking seems like something they have no control over. Telling them to think less may make them feel invalidated, like you don’t appreciate how they feel. Their thoughts are important, real, and worrying.
Often anxiety leads us to imagine the worst possible outcomes of our current circumstances. Even though this is unlikely to us, it’s the most likely scenario for someone with anxiety. Anxiety impacts our ability to switch off from thoughts and properly reason them.
Don’t say anything about using drugs or alcohol to cope or “I have a drink when I get stressed.”
Alcohol is a depressant, it can take the edge off anxiety, but the next day it can increase anxiety. Although alcohol numbs emotions, and you may feel better, it doesn’t help your body tolerate anxiety symptoms. It just reduces them temporarily. The symptoms will still remain at the same level. Helpful strategies include breathing exercises, relaxation exercises, attention training and mindfulness.
Don’t say, “Have you thought about changing jobs/relationships/living situations?
It’s easy to say that the anxiety is situational, and sometimes that might be the case, but generally, it’s a combination of factors. While to you, there might be an easy solution to the problem, it might not be the case for the person with anxiety.
For example, how easy can you change your job/career/relationship when you may be financially dependent? It’s about trying to be there for people and offer a space to listen. Doing this will help empower them to make their own choices. For example, you could say, “Have you considered talking to someone? You can go to your GP or refer online.”
When talking to someone who experiences anxiety, the main takeaway is to be there for them, listen and be supportive. We also have some helpful links for further information and support groups.